Evaluation of several clinical parameters after bleaching with hydrogen peroxide at different concentrations: A randomized clinical trial.

OBJECTIVE: This randomized double-blind clinical trial compared tooth sensitivity (TS), bleaching efficacy, and cytokine levels after applying in-office bleaching treatments containing 15% and 35% hydrogen peroxide (HP15% and HP35%, respectively). METHODS: Twenty-five volunteers were randomly assigned to receive HP15% or HP35% treatment. The bleaching agent was applied in three 15-min applications per session. Two bleaching sessions were separated by a 1-week interval. The participants scored TS using a visual analog scale and numerical rating scale. Bleaching efficacy was determined by subjective and objective methods. Gingival crevicular fluid was collected from three jaws sites per patient for the analysis of fluid volume. Flow cytometry was used to analyze gingival crevicular fluid levels of interleukin (IL)-1ß, IL-2, IL-4, IL-6, IL-10, tumor necrosis factor, and interferon-gamma. All measurements were obtained before and after bleaching. All data were statistically analyzed (α=0.05). RESULTS: The absolute risk and intensity of TS was higher for HP35% than for HP15% (p>0.002). One month post-bleaching, HP35% produced more bleaching than HP15% (p=0.02). However patient perception (p=0.06) and patient satisfaction (p=0.53) with regard to bleaching were not significantly different. No significant differences existed in the gingival fluid volume (p>0.38) or in any cytokine level (p>0.05) for either HP concentration. CONCLUSION: Treatment: with HP35% is more effective than HP15%, but generates a greater risk and intensity of TS. No inflammatory changes occurred despite the difference in the HP concentrations. CLINICAL SIGNIFICANCE: Hydrogen peroxide at a lower concentration (e.g., 15%) should be considered a good treatment alternative for in-office bleaching because the higher concentration for in-office bleaching generates a greater risk and intensity of TS for patients.

Shear bond strength of different surface treatments in bulk fill, microhybrid, and nanoparticle repair resins.

OBJECTIVES: The purpose of this study was to evaluate the influence of surface treatment and different types of composite resin on the microshear bond strength of repairs. MATERIALS AND METHODS: Seventy-two specimens (n=72) were prepared using a nanoparticle resin and stored in artificial saliva at 37 ± 1°C for 24 h. After this period, the specimens (n=24) were restored with microhybrid resin P60 (3M ESPE), nanoparticle resin Filtek Z350 (3M ESPE), and Bulk Fill Surefil SDR Flow (Dentsply) composite resins. Previously, the surfaces of the samples were treated, forming the following subgroups (n=12): (A) conditioned with 37% phosphoric acid for 30 s, and (B) abrasioned with a diamond tip for 3 s and conditioned with 37% phosphoric acid. In all groups, before insertion of the composite resin, the adhesive system Adper Single Bond 2 was actively applied and photopolymerized for 20 s. RESULTS: The microshear test was executed to assess bond strength. Kruskal-Wallis (p<0.05) and Mann-Whitney statistical tests showed significant statistical difference considering that the bulk-fill resin turned out to have a lower bond strength than the conventional nanoparticle and microhybrid composites. With regard to the technique, the roughening with diamond bur followed by the application of phosphoric acid exhibited values higher than the exclusive use of acid. CONCLUSION: The microshear bond strength of the composite resin repairs varies in accordance with the type of composite resin utilized, and roughening the surface increased the bond strength of these materials.